American journal of preventive medicine
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Randomized Controlled Trial
Race and Medication Adherence Moderate Cessation Outcomes in Criminal Justice Smokers.
Smokers in the criminal justice system represent some of the most disadvantaged smokers in the U.S., as they have high rates of smoking (70%-80%) and are primarily uninsured, with low access to medical interventions. Few studies have examined smoking-cessation interventions in racially diverse smokers, and none have examined these characteristics among individuals supervised in the community. The purpose of this study is to determine if four sessions of standard behavioral counseling for smoking cessation would differentially aid smoking cessation for African American versus non-Hispanic white smokers under community corrections supervision. ⋯ Racial disparities in smoking cessation are not evident among those who are adherent to medication. More research is needed to better understand the differential effect that behavioral counseling might have on treatment outcomes between white and African American smokers under community corrections supervision.
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Although smoking prevalence has been declining for smokers without mental illness, it has been static for those with mental illness. The purpose of this study is to examine differences in smoking rates and trajectories of smoking prevalence in the often-overlooked population of smokers with poor mental health, compared with those with better mental health. ⋯ The disparity in which smokers with poor mental health are more likely to be current smokers and less likely to be never smokers as compared with those with better mental health has increased over time. These data suggest the need to more closely examine tobacco control and treatment policies in smokers with behavioral health issues. It is possible that tobacco control strategies are not reaching those with poor mental health, or, if they are, their messages are not translating into successful cessation.
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Although there is general agreement among various guidelines on benefits of routine screening mammography, the age of screening initiation and the optimal frequency of the test remain controversial. In 2009, the U.S. Preventive Services Task Force (USPSTF) recommended against routine breast cancer screening in women aged younger than 50 years. In this study, screening mammography guideline adherence among U.S. women is explored by examining patterns in rates of mammography age of initiation and utilization in years prior to and following the 2009 USPSTF guideline implementation. ⋯ These data support no perceptible change in U.S. women's patterns of screening mammography age at initiation within 3 years of the USPSTF guideline revision. Whether this finding reflects a delayed effect of guideline revision in population trends or rather health provider practice and patient preference for more frequent screening is unclear and requires further investigation.
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Little research to date has explored typologies of physical activity among older adults. An understanding of physical activity patterns may help to both determine the health benefits of different types of activity and target interventions to increase activity levels in older adults. This analysis, conducted in 2014, used a latent class analysis approach to characterize patterns of physical activity in a cohort of older adults. ⋯ This study suggests that individual and neighborhood characteristics are associated with distinct physical activity patterns in a group of older urban adults. These patterns are associated with body habitus independent of overall activity.
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The importance of behavioral counseling as a clinical preventive service derives from the social and economic burden of preventable disease in the U. S., the central role behavioral risk factors play as leading causes of premature morbidity and mortality, and the promise of the healthcare visit as a teachable moment for behavioral counseling support. In November 2013, the U. ⋯ Special focus is on the development and evaluation of evidence from systematic reviews. Assessment of the net benefit of a behavioral counseling intervention, based on the evidence review, determines the recommendation statement and accompanying letter grade. A recent Task Force recommendation on screening and behavioral counseling interventions in primary care to reduce alcohol misuse provides a brief example.